Jaw or Temporomandibular Joint Disorders

Jaw or Temporomandibular Joint Disorders

In the past, my jaw has clicked and appears lopsided when I open my mouth. Recently, I noticed my jaw was rather stiff in the mornings and my muscles tend to ache when I chew my food. I fear my jaw may lock on me. Sometimes, I also suffer from headaches. Is this a serious condition?

Not all clicking sounds need to be treated. However, a worsening click, difficulty in opening the mouth and muscle pain may warrant a visit to the dentist.

Features:

  • jaw pain (muscles and joint) on movement or after waking up
  • clicking jaw joints
  • difficulty in opening mouth
  • jaw ‘stuck’ or locked and dislocated
  • headaches

Causes:

  • subconscious night grinding or clenching of teeth. Most patients who do so are usually unaware.
  • emotional stress and anxiety
  • extraction or trimming of the opposing tooth to reduce biting on the swollen gum
  • bad jaw habits e.g. chewing on hard foods, chewing on one side
  • poor teeth alignment leading to a bad bite
  • systemic diseases e.g. arthritic disorders

Identification:

  • palpable pain on jaw muscles, joint and head
  • limitation in mouth opening
  • excessively worn, cracked teeth, fillings and prostheses
  • X-ray may show bone changes. Magnetic Resonance Imaging may show position of displaced disc.
  • questionnaires on medical and chronic pain history

Management:

  • patient education and reduction of jaw use
  • splints fitted over teeth to reduce further damage
  • medication
  • counselling sessions
  • heat and ultrasound physiotherapy
  • arthrocentesis – jaw joint manipulation
  • arthroscopy – jaw joint surgery aided by miniature camera
  • occlusal rehabilitation to stabilise jaw function